Provider Demographics
NPI:1215347760
Name:VELK, ANGELA KAY (DDS)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAY
Last Name:VELK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32475 CLINTON KEITH RD STE 115
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-8664
Mailing Address - Country:US
Mailing Address - Phone:951-609-0445
Mailing Address - Fax:951-609-1338
Practice Address - Street 1:32475 CLINTON KEITH RD STE 115
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-8664
Practice Address - Country:US
Practice Address - Phone:951-609-0445
Practice Address - Fax:951-609-1338
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist